Healthy Skepticism Library item: 2426

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Publication type: Journal Article

Miller DW, Miller CG.
On Evidence, Medical and Legal.
Journal of American Physicians and Surgeons 2005 Fall; 10:(3):70-75
http://www.jpands.org/vol10no3/miller.pdf

Abstract:

Introduction
Medicine, like law, is a pragmatic, probabilistic activity. Both
require that decisions be made on the basis of available evidence,
within a limited time.
In contrast to law, medicine, particularly evidence-based
medicine as it is currently practiced, aspires to a scientific standard
of proof, one that is more certain than the standards of proof courts
apply in civil and criminal proceedings.
But medicine, as Dr. William Osler put it, is an “art of
probabilities,practice medicine by using other evidentiary standards in addition
to the scientific.” To employ only the scientific standard of proof is
inappropriate, if not impossible; furthermore, as this review will
show, its application in medicine is fraught with bias.
Evidence is information. It supports or undermines a
proposition, whether a hypothesis in science, a diagnosis in
medicine, or a fact or point in question in a legal investigation. In
medicine, physicians marshal evidence to make decisions on how
to best prevent, diagnose, and treat disease, and improve health. In
law, courts decide the facts and render justice. Judges and juries
assess evidence to establish liability, to settle custody and medical
issues, and to determine a defendant’s guilt or innocence.